Presentation (CTI)

OBJECTIVES: Feasibility assessments are a critical preliminary step in determining whether indirect treatment comparisons (ITCs) can be robustly conducted and which methods are most suitable. However, approaches to assessing feasibility are not standardised and are often inconsistently reported. This study reviewed National Institute for Health and Care Excellence (NICE) technology appraisals (TAs) to characterise how ITC feasibility assessments are conducted, identify common practices, and explore gaps in reporting.
METHODS: A targeted review of NICE TAs published between April 2023 and April 2026 was conducted. Terminated appraisals were excluded. Data extraction was based on initial company evidence submissions and focused on: 1) whether an ITC was conducted and its type, 2) whether an ITC feasibility assessment was conducted and terminology used, and 3) the aspects of ITC feasibility assessed.
RESULTS: Of the 213 TAs identified, 144 included an ITC. Feasibility assessments were reported in 138 initial submissions (126 with an ITC, 12 without). Terminology and reporting varied considerably across appraisals. While 73% explicitly used the term “feasibility assessment”, others described the process using non-standardised terminology. Across key components of feasibility assessments, population characteristics and study design were most consistently assessed (80 and 76%, respectively), followed by outcome definitions and reporting (71%). Explicit reporting of treatment effect modifiers and prognostic variables was less frequent (64%). Notably, 55% of TAs indicated that more detailed feasibility assessment findings were provided in appendices that were often not publicly available.
CONCLUSIONS: ITC feasibility assessments in NICE TAs show substantial variability and limited transparency, with detailed reporting often confined to non-public appendices. With the emergence of the EU Joint Clinical Assessment (JCA) and its accompanying methodological guidance, the need for consistent and transparent feasibility assessments is becoming increasingly important. Development of a general feasibility framework could improve standardisation and enable clearer, publicly accessible reporting, thereby strengthening confidence in ITC-related evidence.